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Control substance, diversion prevention > Chapter 2 Control Substance Drug Diversion > Flashcards

Chapter 2 Control Substance Drug Diversion Flashcards

1
Q

It is any criminal act or deviations that removes a prescription from its intended path from the manufacture to the intended patient

A

What is drug diversion?

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2
Q

Types and functions of security control measures, devices, and software to detect and prevent diversion

A

Nursing managemen
Audit
Automated dispensing devices
Camera systems
Discrepancy measures
Documentation guidelines.

. 

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3
Q

High risk areas of the pharmacy

A

The Pharmacy itself
In transition.
Receiving
Narcotic volt?
Operation rooms
Will call
IV room
emergency department

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4
Q

Element of a comprehensive and effective controlled substances diversion prevention programs (csdpp)

A

— Core administration elements
Legal and regulatory requirement.
Organization, oversight, and accountability.
—System level control.
Human Resources management
Automation and technology.
Monitoring and surveillance
Investigation and reporting.
— provider level controls.
Chain of custody.
Storage and security
Internal pharmacy control
Prescribing and administration?
Returned, waste, and disposal.

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5
Q

-Procurement, prescribing, and administration and transfer of controlled. Substances are highly regulated by federal/state laws and compliance is Sanders.
-Billing and fraud implications
-DEA registrations.
-Patient all medication’s, medical cannabis, marijuana, and illicit substances

A

Core administration elements
-Legal and regulatory requirement

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6
Q

-Controlled substance management program should be in place with proven compliance
-authorized personnel trained.
-inter disciplinary committee to provide leader ship, and direction
-Drug diversion respond team

A

Core administration element

-Organization, oversight, and accountability

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7
Q

-Human resource management
-Automation and technology
-Monitor and surveillance
-investigation and reporting

A

System -level controls

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8
Q

-implement policy to protect patient from potential harm related to substance abuse and diversion
-orientations and annual education.
-Support recovery

A

System level controls
-Human resource management

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9
Q

Interdisciplinary team to select and implement all medication related automated systems and technology.
-Record keeping.
-Systems used in high-risk area.
-Authorized personnel trained
-Policy and procedures for downtime

A

System level controlled
-Automation and technology

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10
Q

Implement policy to protect patients from potential harm related to substance abuse and infection.
Orientation an annual education
Support recovery.

A

System level control.
-Human resource management

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11
Q

Interdisciplinary teams to select and implement all medication related—?
.?..

Record keeping.
Systems use in high risk area.
Authorized personnel trained
Policy and procedure for downtime

A

System level controls.—-automation system control
-Automation and technology

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12
Q

-Compliance reviews,
-surveillance trends
-Completeness of investigation and reporting
-confirmed corrective action.
-Diversion prevention, system improvements

A

System level controls
-Monitoring and surveillance

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13
Q

-guidance on who will conduct the investigation
-Investigation are conducted throughly and completely as possible.
-If an employee is arrested for illicit use of controlled substances, and investigation should occurred
-guidelines for engaging external entities.
-DA form 106 unresolved discrepancy

A

System level controls.
—Investigating and reporting.

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14
Q

-transfer of controlled substance occurring between individuals whether internal or external
-Ensure the integrity and security of controlled and safety of personnel transporting.
-Control substances in emergency medical services should comply with local and state and requirements

A

Provider level controls.
-Chain of custody

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15
Q

-stored in locked and secured location
-locked out times for electronic lock on count.
-Only authorized personnel have access.
-Way to track keys if needed
-video surveillance in high traffic areas
-Automated dispensing utilize.
-Pharmacy inventory is monitored.
-Narcotic count as verify each time in area is access with control substance

A

Provider level controlled.
— storage and security

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16
Q

-Procurement controls
— always procured from the pharmacy.
— purchasing safeguards.
—-electronic ordering system— no paper 222 forms
—— to Authorized individuals count and narcotics.
—-process in place to discrepancies
—-control and documentation for transferred to another pharmacy.
—-paperwork is audited.

A

Providers level controls.
-Internal pharmacy controls
—— procurement control

17
Q

-perpetual inventory.
-Blind check when removing narcotic.
-Access to inventory is limited.
-Drug products inspected
for tampering
-unit dose packaging is purchased when available.
-Delivery off narcotics should have auditable verification.
-Returned should have an editable procedure


A

Provider level control
-internal pharmacy controlled.
— preparation and dispensing controls

18
Q

-narcotic should be in ready to use form
-Unused medication should be disposed of immediately
-When wasting, there should be a witness.
-All disposal guidelines in accordance with a recommendation Guidelines
-Waste container should not allow for the retrieval of any medication.
-Items that are reusable should be returned to automated machine with witness.
-Expired narcotic should be clearly labeled.
-D EA Registrant or destiny should assist with all phase of narcotic disposal

A

Providers level controls
-Return, waste and disposal

19
Q

-controlled substances can only be ordered by licensed authorized prescriber with DEA authorization
-there should be a process in place to identify the prescriber.
-Refills and time authorization should be within limited range.
-Prescriber should not prescribe for themselves for family (not ethical)
-Or syringes with narcotic are labeled
-Process in place when automated devices are not use for administrator purpose

A

Provider level control
— prescribing and administration

20
Q

-procurement
-Preparation and dispensing.
-Describing
-administrations
-Waste and removal

A

Areas of vulnerability

21
Q

-purchase order or package slip Remove from records
-unauthorized individuals order for control substance on stolen DEA phone 222
-Product container compromise

A

Area of vulnerability

—Procurement

22
Q

-CS are replaced by product, similar appearance when repackaging
-Removing volume from premixed infusion
-Multidose vial overfill diverter
-Prepare syringe content I replaced with saline solution

A

Area of vulnerability
—preparation, and dispensing

23
Q

-Prescription Pad and I bought it in for to obtain CS
-Prescriber self prescribed CS
-Verbal orders for Cs create , but not verified by provider
-written prescriptions altered by patience

A

 Area of vulnerability
— prescribing

24
Q

-CS withdraw from an automated dispensing device on discharged or transferred patient.
-medication document ask given, but not administered to patient
-waste is not adequately witnessed and subsequently diverted
-substitute drug is removed and administered while CS is diverted 

A

Area of vulnerability
— administration

25
Q

-CS waste is removed from unsecure waste
-CS waste in syringe is replaced with saline
- expired CS are diverted from holding area

A

Area of vulnerability
— waist and removal

26
Q

-an employee cannot alter the audit tree for the chain of custody
-Measures should be in place to ensure the integrity and security of CS and the safety of personnel, transporting CS to offsite location
-Secure, lockable, and tampering evident delivery containers that do not make know what is being transported
-should be traceable.
-Audit tray should be maintained at all times and at a point when they transfer of CS occur between individual
—-carrier transferred to other facilities
— use of pneumatic tube system
— transfer to emergency medical service provider
— transfer from Contacts pharmacy services

A

Chain of custody

27
Q

Learning objective

A

-Area of vulnerability in procurement, preparation, and dispensing, prescribing, administration, and waste/removal process.
-Element of comprehensive and effective Controlled Substances, Diversion Prevention program(CSDPP)
-type and function of security control measures, devices, and software to detect and prevent divergent. (Example looking storage, cameras, ADC, analytics, software.)
-high risk areas of the pharmacy ( eg anesthesia areas , CS vault,IV room,, will call, receiving)
-chain of custody method s ( eg
regulation of access control, presence of witnesses for signing delivery sheets, use of tampering evident containers )

28
Q

-Chain of custody.
-Storage and security.
-Internal pharmacy control.
-Waste returns and disposal.
-Prescribing and administration

A

Provider level control

29
Q

-procurement
-Preparation and dispensing.
-Prescribing
-Administration
-Waste and removal.

A

Areas of vulnerability

30
Q

-purchase order and packing slip removed from records.
-Un authorize individual order for CS on stolen DEA form 222
-Product container compromise

A

Areas of vulnerability

—Procurement

31
Q

-CS are replaced by product of similar appearance when repackaging
-removing volume from premixed infusion.
-Multiple dose overfilled diverted
-Repair syringe contacts are replaced with saline solution

A

Areas of vulnerability

—Preparation and dispensing

32
Q

-Prescription pads , diverted and forged obtain CS
-Prescriber self prescribed CS.
-Verbal orders for CS created , but not verified by prescriber
-Written prescription altered
by patient

A

AREAS of Vulnerability
Prescribing

33
Q

-CA a Re withdraw from an automated dispensing device on discharge or transfer patient
-medication documented as given, but not administered to patient
-Waze is not adequately witnesses and subsequently a diverted
-Substitute drug is removed and administered it while CS is diverted

A

Areas of Vulnerability

-Administration

34
Q

-
Cs is waist is removed from unsecure waste container -
-CS waste in syringe is replaced with saline.
-expired CS are converted from holding area

A

Area of vulnerability

—Waist and removal

Control substance, diversion prevention (12 decks)

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